Provider Demographics
NPI:1841249158
Name:MEYERS, BRUCE C (DPM)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:C
Last Name:MEYERS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1315
Mailing Address - Country:US
Mailing Address - Phone:248-652-8050
Mailing Address - Fax:248-652-8051
Practice Address - Street 1:969 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1315
Practice Address - Country:US
Practice Address - Phone:248-652-8050
Practice Address - Fax:248-652-8051
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901000915213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5901000915OtherMICHIGAN STATE LICENSE
MIP4844OtherBLUE CROSS NEW YORK
MI4856351130OtherBLUE CROSS BLUE SHIELD
M009659OtherCHAMPUS
MI2103562Medicaid
480000692OtherMEDICARE RAILROAD
ILC005635113OtherBLUE CROSS
MI5635113OtherMEDICARE TPAN
MIP4844OtherBLUE CROSS NEW YORK
MI0993010001Medicare NSC
5635113Medicare ID - Type Unspecified
MIP4844OtherBLUE CROSS NEW YORK
ILC005635113OtherBLUE CROSS